Surgical treatment for epilepsy: the potential gap between evidence and practice
Summary Findings from randomised controlled trials, along with more than 100 case series and observational studies, support the efficacy and safety of resective surgery and, more recently, non-resective surgical interventions for the treatment of drug-resistant epilepsy in appropriately selected ind...
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| Veröffentlicht in: | Lancet neurology 2016-08, Vol.15 (9), p.982-994 |
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| container_title | Lancet neurology |
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| creator | Jetté, Nathalie, Prof Sander, Josemir W, Prof Keezer, Mark R, MDCM |
| description | Summary Findings from randomised controlled trials, along with more than 100 case series and observational studies, support the efficacy and safety of resective surgery and, more recently, non-resective surgical interventions for the treatment of drug-resistant epilepsy in appropriately selected individuals. There is an argument that epilepsy surgery remains underused, but the evidence to support this assertion is at times unclear. Results from longitudinal studies show a stagnant or declining rate of epilepsy surgery over time, despite the evidence and guidelines supporting its use. Some suggest that this stagnation is due to a decreasing pool of eligible surgical candidates, whereas others emphasise the numerous barriers to epilepsy surgery. Strategies exist to increase access to surgery and to improve communication about the effectiveness of this potentially life-changing procedure. Further investigation into the nature and causes of the presumed underuse of epilepsy surgery and the elaboration of strategies to address this treatment gap are necessary and pressing. |
| doi_str_mv | 10.1016/S1474-4422(16)30127-2 |
| format | Article |
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There is an argument that epilepsy surgery remains underused, but the evidence to support this assertion is at times unclear. Results from longitudinal studies show a stagnant or declining rate of epilepsy surgery over time, despite the evidence and guidelines supporting its use. Some suggest that this stagnation is due to a decreasing pool of eligible surgical candidates, whereas others emphasise the numerous barriers to epilepsy surgery. Strategies exist to increase access to surgery and to improve communication about the effectiveness of this potentially life-changing procedure. 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Further investigation into the nature and causes of the presumed underuse of epilepsy surgery and the elaboration of strategies to address this treatment gap are necessary and pressing.</description><subject>19th century</subject><subject>Animals</subject><subject>Drug resistance</subject><subject>Epilepsy</subject><subject>Epilepsy - surgery</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Low income groups</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Neurosurgical Procedures - methods</subject><subject>Patients</subject><subject>Randomized Controlled Trials as Topic - statistics & numerical data</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>1474-4422</issn><issn>1474-4465</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkUtv1TAQRi0EoqXwE0CW2JRFwJ7YTsIChCpeUiWQCmvLj0lxyU1S2ym6_x7n3kuRuoGVX8dnNPMR8pSzl5xx9eqCi0ZUQgCccvWiZhyaCu6R48O1kvdv9wBH5FFKV4wBFy1_SI6gEU3bSXlMvl4s8TI4M9Ac0eQNjpn2U6Q4hwHntH1N8w-k85TLQyjUpZmpxfwLcaR4EzyODqkZPZ2jcTk4fEwe9GZI-OSwnpDvH95_O_tUnX_5-Pns3XnllFC5aoH5HoDLpgffOWFq67w0TlnrmPWuk9C2neWq9ODBGSl9V_eqsRx901tRn5DTvXeO0_WCKetNSA6HwYw4LUnzlrWqVpJ1_4eyUg8K-vwOejUtcSyNrJQUChq-CuWecnFKKWKv5xg2Jm41Z3pNR-_S0evodTnt0tGr_dnBvtgN-ttff-IowNs9gGVyNwGjTi6sI_YhosvaT-GfJd7cMbghjGvAP3GL6W83OoFme8nq4GpngPo3d26y1g</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Jetté, Nathalie, Prof</creator><creator>Sander, Josemir W, Prof</creator><creator>Keezer, Mark R, MDCM</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C2</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160801</creationdate><title>Surgical treatment for epilepsy: the potential gap between evidence and practice</title><author>Jetté, Nathalie, Prof ; 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| subjects | 19th century Animals Drug resistance Epilepsy Epilepsy - surgery Humans Longitudinal Studies Low income groups Mortality Neurology Neurosurgical Procedures - methods Patients Randomized Controlled Trials as Topic - statistics & numerical data Surgery Treatment Outcome |
| title | Surgical treatment for epilepsy: the potential gap between evidence and practice |
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